2 Minute Medicine ® - Sleep Medicine

1. In this cross-sectional study, there was a negative association between sleep duration and dental caries. 2. Furthermore, those who slept an average of ≥7 hours were less likely to have dental caries than those who slept <7 hours. Evidence Rating Level: 2 (Good) Dental caries are highly prevalent worldwide and can significantly impact overall health and quality of life in patients. A lack of sleep can be associated with inflammation, reduced immune function, and increased susceptibility to many conditions...

1. In this cross-sectional analysis, long sleep duration (≥9 hours) was significantly associated with carotid plaque presence and larger total plaque area. 2. However, short sleep duration and daytime sleepiness showed no association with carotid plaque burden. Evidence Rating Level: 2 (Good) Sleep is an essential part of cardiovascular health, as the American Heart Association outlines. Prior studies have indicated a relationship between sleep duration and stroke risk. However, the pathology behind this association has yet to be well studied...

1. In this systematic review and meta-analysis, short sleep duration, long sleep duration, and insomnia were associated with higher odds of multimorbidity. 2. There were also associations between multimorbidity and snoring, obstructive sleep apnea, and restless leg syndrome. Evidence Rating Level: 1 (Excellent) It is well known that those who experience sleep problems, including insomnia and obstructive sleep apnea, are more susceptible to chronic health conditions. Multimorbidity is the existence of two or more chronic health conditions in a given individual...

1. In this retrospective study, it was found that inflammatory bowel disease (IBD) activity was associated with poorer sleep scores in pediatric patients. 2. Furthermore, pediatric patients with IBD demonstrated poorer overall sleep compared to controls, as evidenced by a later sleep time and shorter sleep duration in IBD patients. Evidence Rating Level: 2 (Good) Sleep disturbances are common among patients with inflammatory bowel disease (IBD), and there is a well-identified link between sleep disorders and conditions of the gastrointestinal tract...

1. In this randomized controlled trial, patients who received digital cognitive behavioral therapy (dCBT) demonstrated improvements in insomnia symptoms compared to the control group. 2. Although there were also improvements in sleep-onset latency and mood in those who received dCBT, there was no significant improvement in quality of life. Evidence Rating Level: 1 (Excellent) Stroke survivors tend to suffer from long-term sleep disruption, negatively impacting their quality of life. Cognitive behavioral therapy (CBT) is often prescribed for the treatment of insomnia, but its role in improving sleep disruption in stroke patients has not been well established...

1. In this randomized controlled trial, the Eat, Sleep, Console approach resulted in a significantly shortened time to medical readiness for discharge in neonates with opioid withdrawal syndrome.  2. There was no significant difference between usual care and the Eat, Sleep, Console approach in the incidence of adverse outcomes.  Evidence Rating Level: 1 (Excellent) Study Rundown: Neonatal opioid withdrawal syndrome results from exposure to opioids in utero. Clinical signs can include seizures, irritability, and gastrointestinal issues...

  1 . Increased time in bed through advancing bedtime in adolescents was associated with increased sleep duration. 2. Total sleep time increased by 41.5 minutes for every additional hour spent in bed. Evidence Rating Level: 2 (Good) Study Rundown: Decreases in sleep duration throughout adolescence are linked to negative academic and mental health outcomes. This prospective cohort study sought to identify the impact of an intervention consisting of advancing adolescent bedtimes to increase time in bed (TIB), on total sleep time and quality of sleep...

1. In this systematic review and meta-analysis, it was found that in patients with obstructive sleep apnea (OSA), inspiratory muscle training likely had a positive impact on systolic blood pressure and sleepiness, but demonstrated no improvements in apnea-hypopnea index, forced vital capacity, sleep quality, and quality of life, compared to controls. 2. Meanwhile, expiratory muscle training showed some improvements in expiratory muscle strength and sleep quality compared to controls, but no improvements in sleepiness...

1. In this systematic review, substance use impacted various sleep characteristics in young adults, but the impact was dependent on the substance. For example, both caffeine and nicotine use were associated with higher odds of sleep disturbance, while nicotine alone was associated with poor sleep satisfaction. 2. Furthermore, evening chronotype, the preference to conduct activities in the evening, was associated with alcohol, caffeine, and nicotine use. Evidence Rating Level: 1 (Excellent) Young adults have high reports of both sleep difficulties and substance use...

1. In this prospective study, preventative therapy with the ketogenic diet (KD) was associated with sleep improvements in migraine patients, including a decrease in patients with insomnia and a reduction in excessive daytime sleepiness (EDS). 2. Furthermore, KD therapy was associated with improvements in migraine symptoms, including reduced frequency and lower intensity headaches. Evidence Rating Level: 2 (Good) Migraines are one of the leading causes of disability worldwide and are associated with impaired quality life...

1. For patients with insomnia, digital cognitive behavioural therapy (dCBT-I) and combination of dCBT-I and sleep medication were associated with higher response rates and greater improvements in sleep quality compared to medication alone, at 6 months follow-up.  Evidence Rating Level: 2 (Good) Study Rundown:   Digital cognitive behavioural therapy for insomnia (dCBT-I) refers to the delivery of CBT-I content through cellular apps or the Internet. dCBT-I has demonstrated effectiveness in improving sleep quality and reducing insomnia severity...

1. In this randomized controlled trial, the combination of an eye mask sleep position device and oral appliance therapy was significantly more effective than either treatment alone for improving apnea-hypopnea index (AHI) in positional obstructive sleep apnea (OSA). 2. The combination therapy was also associated with higher rates of effective treatment at 6 months compared to either intervention alone. Evidence Rating Level: 1 (Excellent) Obstructive sleep apnea (OSA) is a sleep-breathing disorder linked to serious cardiac complications, public safety risks, and higher all-cause mortality...

1. In this systematic review and meta-analysis, it was found that among critically ill patients in the intensive care unit, the combination of earplugs, eye masks, and music was the most effective for improving sleep quality. 2. Individually, the most to least effective interventions for better sleep quality were the following: eye masks, bedtime music, quiet time, and earplugs. Evidence Rating Level: 1 (Excellent) Sleep quality in the intensive care unit (ICU) is often poor due to high levels of noise and nighttime light...

1. This cross-sectional cohort study determined that there was an increased relative risk of sleep disturbances in adults who have previously suffered a stroke compared to those who have not.  Evidence Rating Level : 2 (Good) The experience of sleep disturbances for stroke patients is thought to be an important factor contributing to low mood, fatigue, impaired activities of daily living, and overall poorer post-stroke rehabilitation. Despite this, previous research has not adequately quantified the prevalence of sleep disturbances in this population...

1. In this prospective cohort study, military members who reported a post-traumatic stress disorder (PTSD) diagnosis at the first timepoint were significantly more likely to develop obstructive sleep apnea (OSA) alone, or the combination of OSA and insomnia, at the second timepoint. 2. Furthermore, a diagnosis of OSA and/or insomnia at the first timepoint significantly increased the likelihood of a new PTSD diagnosis or the development of PTSD symptoms at the second timepoint. Evidence Rating Level: 2 (Good) Post-traumatic stress disorder (PTSD) is very common among military members...

1. In this meta-analysis, it was found that the pooled prevalence of sleep-related breathing disorders (SRBDs) among dementia patients was 59%. Obstructive sleep apnea (OSA) was the SRBD with the highest prevalence, at 55%, followed by unspecified SRBDs. 2. Furthermore, the highest prevalence of SRBDs among dementia subtypes was Alzheimer’s dementia, followed by Parkinson’s dementia. Evidence Rating Level: 1 (Excellent) Sleep-related breathing disorders (SRBDs), including obstructive sleep apnea (OSA), central sleep apnea (CSA), and other unspecified disorders, are very common among people with dementia...

1. In this cross-sectional study, it was found that participants had lower overall sleep health following a COVID-19 infection compared to pre-infection sleep levels. 2. Furthermore, COVID-19 symptom severity was found to be a significant predictor of poor overall sleep health. Evidence Rating Level: 2 (Good) COVID-19 has infected millions of people around the world and has been known to exhibit short-and long-term effects. Although research has identified numerous neurocognitive sequelae of COVID-19, such as brain fog, and memory impairments, there has been limited research into the impacts of the infection on long-term sleep outcomes...

1. Self-reported and clinically diagnosed poor sleep are associated with lower cardiovascular disease-free life expectancy, compared to patients with healthy sleep. Evidence Rating Level: 2 (Good) Poor sleep has been associated with greater risk of cardiovascular disease (CVD). A previous study found a 39% greater risk of CVD mortality in poor sleepers compared to healthy sleepers. However, there is a paucity of evidence pertaining to the association between sleep and CVD-free life expectancy at age 40. Therefore, this cohort study estimated the CVD-free years of life lost for patients with self-reported and clinically diagnosed poor sleep...

1. In this randomized controlled trial, post-operative treatment with methylprednisolone was associated with improvements in pain management and subjective sleep quality in patients following hip arthroplasty. 2. Additionally, length of hospital stay was significantly shorter for patients who received a single steroid intervention. Evidence Rating Level: 1 (Excellent) Advancements in total hip arthroplasty (THA) have allowed for shorter hospital stays and better recovery outcomes. Pain after surgery continues to be a key reason for extended hospital stays and additional cost to the healthcare system...

1. In this randomized controlled trial, sleep onset latency was significantly decreased in children with autism spectrum disorder who received melatonin compared to those who received placebo. 2. Furthermore, there were no serious adverse events or deaths associated with melatonin. The most common adverse events were infections, nervous system disorders, and pharyngitis. Evidence Rating Level: 1 (Excellent) Autism spectrum disorder (ASD) is a neurodevelopmental disorder that can affect children’s social behaviours, cognitive aptitudes, and sleep quality...